Giving fitness direction in the age of confusion.
From strength and conditioning to ultrarunning. Stopping at corrective exercise and olympic lifting along the way, and visiting everywhere in between...

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Tuesday, February 21, 2017

Every habit you have is embedded in your memory somewhere. For part 1,2,3, go here, here and hereThe more you practice a habit, the more the neural pathways are laid down. The pathway gets stronger and the memory becomes consolidated. As the neuroscience adage says 'neurons that fire together, wire together'.But you memory is unreliable. It does not store fixed digital files, they change over time. Less like a digital photo and more like a painting you keep adding to and re-touching. Your memory of playing frisbee at 10 years old is different when you remember it at 14 years old to when you remember it at 50 years old.You will have attachments to certain activities and foods beyond the utility of getting enough calories to survive and filling up your days with stuff to do.Think of all your favourite comfort foods, they will probably have a memory attached to them. A roast dinner at your grandparents, a cheese sandwich after school, being given a certain chocolate bar as a treat. That food you had once on an amazing holiday.And you may have an aversion to other foods because of a bout of food poisoning, or that time you got so drunk on Sambuca that you can never face drinking it again.And you cannot escape your culture.Pepsi vs Coca Cola.

In one famous study (McClure et all, 2004) the researchers compared peoples brain activation in an fMRI scanner when they were drinking Pepsi and Coca Cola. They are both essentially brown sugary drinks, so should activate the same areas of the brain.

When the participants didn’t know whether they were drinking Pepsi or Coca Cola the VMPFC lit up, an area of the brain that relates to taste.

However, when they were told they were drinking Coca Cola the DLPFC and hippocampus were activated. This didn’t happen when people thought they were drinking Pepsi.The DLPFC is involved in working memory and perception based on previous experience. The hippocampus is involved in memory recall.The coca cola was causing a memory recall in people, not just a taste sensation. The influence of culture and brand knowledge had made their brain remember Coca Cola (bear in mind they didn’t actually have to drinking Coca Cola for this to happen, they just had to think they were).

If you're American this is probably embedded in your memory, whether you want it to be or not.

Interestingly, the memory parts of the brain were not activated for Pepsi. And even the people who had a stated preference for Pepsi only showed activation of the memory parts of the brain when they though they were drinking Coca Cola.This study was in the USA, and shows how much Coca Cola is part of peoples culture and upbringing in that part of the world.For me this wouldn’t happen for Coca Cola, but it would probably happen for a cheese sandwich on white crusty bread and a cup of tea. These were more significant foods and drinks for me. Or possibly even Tizer, or Irn Bru if your Scottish!

If you're British and of a certain age this is in your memory. If you're American or Chinese this means nothing.

You cannot separate yourself from your culture or your memories which are hard wired into your brain.

Now think back to exercise. If someones memory of exercise is being made to do it at school, going for runs in the freezing cold and hiding behind the cricket pavilion for a cigarette; this is what they think of when they think of running. However, they may have more positive associations with dancing or cycling. Who doesn’t like riding their bike as a kid? Or swimming on holiday?Spreading activation. Run = school = cold = bullying PE teacher!Spreading activation theory is how your brain groups things together.The networks in your brain seem to group words and objects together. Think pets, and you brain might thing dog or cat (in western culture) . You can prime someone by using associated words. Say the word carrot, and someone takes longer to recall the word doctor, say the word ‘nurse’ and they recall the word doctor a lot quicker.Your neural network is dependent on your experience and your culture. You could prime yourself by associating certain feelings and words with exercise.For example, for me running is not like the example above, but is running with my Dad as a kid - going to cool places, being outside.And for a lot of new people going to the gym, especially women, I suspect that when you mention the words 'lifting weights' there neural network goes with the only examples it knows: weights = olympic = massive guys lifting massive weights = masculine/drugs. But could you change this, can you create a new pathway?False Memories.Elizabeth Loftus and her team were the first team to show you could implant a false memory in people, the memory was of being lost in a shopping mall as a child. It has to be a plausible memory, it is less likely you could implant the memory that someone climbed Everest as a child.They have also managed to do it with food (Bernstein et al, 2011). In one study (where the participants did not know it was about false memory, but about food preferences) the researchers managed to plant false memories in subjects to make them believe they had a bad experience with egg salad or strawberry ice cream ( up to 40% of participants). So much so that when offered these food one week or several months later they avoided them.They also managed to plant a false memory about a 'healthy food', in this case, Asparagus, making them believe they love it the first time they had eaten it. They managed to convince 50% of participants they had loved Asparagus the first time they had eaten it. They then offered them a choice of foods to eat at a later date, the people with the false memory chose Asparagus more than those without the false memory. The participants with the false memory also said they would pay more for asparagus and choose it as a preferred food to have several months after the study.

You can be made to think you loved this the first time you ate it. Maybe you really did?

However, they were unable to plant false memories about a bad experience in the past or fake food poisoning with cookies (biscuits) or potato chips (crisps). This could be because these food are too tasty to give up and too common OR it could be intuitively as humans we generally know we don't get food poisoning from crisps.Also, note they were not able to plant the false memory in everyone, more than half the people did not accept the memory.The researchers also managed to do it for alcohol as well.From a real memory point of view this makes sense, you aversion to Sambuca after that heavy night of shots years back or that terrible bout of food poisoning means you avoid a certain restaurant or seafood. And if you are allergic to something like peanuts or red wine your are very likely to avoid it.Whats less clear is if you could deliberately plant a false memory in your self, while knowing you are actually doing it.Be careful!There is something called covert sensitization, which is essentially the idea of gradually associating a feeling of nausea/sickness with a food until you don't want it. Of course, this may result in you never wanting a food, even something as tasty as cheese. And lets not forget obesity and healthiness goes beyond one food group.More useful could be the idea of making yourself want healthy foods more. And then associating these healthy foods with healthy words and healthy positive images in your brain.You could make yourself remember that you loved running at school, you liked all vegetables as a kid and can't get enough of them.Of course, there are techniques that people already use like hypnotism and NLP. Even though these have been considered fringe methods up until now, the research which uses quite basic methods of visualization shows there could definitely be some merit in some of these approaches. This is not going to happen over night, like all visualization techniques you have to practice.What is real and not real?There is another famous study, where one group of people learned to play a sequence on the piano actually sitting at the piano, and another group visualized practicing it. After 5 days, both groups showed an increase in the motor cortex where the fingers are controlled from in the brain.Think about this for a second, not only did it show the brain in adults is plastic and can physically change when learning a new skill. It can be changed just by visualizing a new skill!Now, you have to make your visualization targeted, you can't just sit there and pretend you are Elton John or Jimi Hendrix. You have to make your visualization a clear practice.And one last study for you, Ganis et al (2004) Got one group of participants to look at a sketch of a shape, and another group to imagine the shape while in an fMRI scanner. There was a lot of overlap in the regions of the brain activated, in fact about 90%. There wasn't complete overlap, but there was a large amount of similarity.This shows how powerful imagination can be.Take home.Hopefully, this has shown that your brain and habits are not fixed. After all people give up smoking and start exercising every day, and some stick with it.You brain is plastic, you can change how you think about things and what your memories are 'telling' you.Always remember that what you believe and remember and like are all products of the culture you were brought up in, at a certain point in history. And even though these things can be quite deeply embedded, there is no reason why you can't use strategies of visualization and mental imagery to change the things that are may be not working for you now.You can visualize new skills, you can create positive word associations with healthy foods and exercise and probably even convince yourself how much you love vegetables. But, be careful, don't create a permanent aversion to cheese or coffee or bread - what could be worse. Live your life!

Sunday, February 12, 2017

In this series I will cover the best training splits, the optimal number of exercises per body part and per session, the optimal sets and reps, the best training techniques and the best exercises for each body part. First up, what is the best training split?

What you training today bro? Chest & Tri's.

It's a conversation repeated in every gym around the world on a daily basis.

I hadn't trained for hypertrophy for years, all my training was total body, in the strength and power range with the occasional conditioning session. Power cleans, squats, push press, plyometrics, with some unilateral work. Throw in some core and occasional 'pre-hab' work. Generally things to make me better at running up mountains, and keep athleticism and strength with minimum time in the gym. Of course I would throw in a bicep curl every now and then if I had time.

Then I lost my mojo, got injured, had enough of the gym, quit for three months to try some other things like rock climbing and yoga. Then I joined a new gym, which had way more machines and it was time to try something new. And so begun experiments in hypertrophy.

I wrote down everything exercise I knew, I then asked people what their favourite exercise for a body part was, what training split and methods they used; I wrote that down too. Then for several months I tried all different types of splits, exercises combinations and methods.

The science.

Of course I checked out the research. Brad Schoenfeld is your go to man.

You can see his work on number of sets here, rep ranges here, how many times a week should you train a muscle here

In summary

1)Meta analysis by
Brad Schoenfeld shows that hitting a muscle group twice a week is
optimal when trying to maximize gains, but gains can still be made
hitting a muscle group just once a week.

2) 10 plus sets per
week caused almost twice as many gains as doing 5 sets per week. But
there is no known upper threshold yet (where gains start to go down). Note, the dose of sets is over a week NOT necessarily in one training session.

3)And also a variety
of rep ranges work.

In terms of rep ranges Schoenfelds study shows muscle growth in rep ranges from 8 up to 35 (yep 35 reps, sorry all you ladies in toning classes, there is a good chance you are still building muscle) and this was in trained subjects.

Of course, as always
with research, the studies tend to be short, there is individual
difference, and there is always a grey area of what exercise is working
what muscle group*(see my definition at the end) with multi-joint exercises, when do your work sets
start**(see my definition at the end) etc.

So, we know a
variety of rep, set and training frequency schemes all work. But
generally training a muscle group twice a week for more that 10 sets
using a variety of rep ranges is probably optimal.

But of course,
everyone is individual and what is optimal is also what you are going
to do and enjoy.

Rodins Thinker: Since the beginning of time people have pondered whether to combine chest and biceps on the same day.

The rules.

I used the holy trinity of broscience to test if it was worth doing an exercise or split:

1) Could I feel the muscle I was targeting with a particular exercise
2) Did I get a pump
3) Was that muscle sore the next day (I know, there is no correlation with soreness and growth but who doesn't feel like soreness = you worked a muscle)

And in the long term could I see visual changes in a muscle. There a few caveats, for example, I can make my chest sore pretty easily, and my biceps, my legs generally don't get sore (I think from all that trail running) and I never met anyone who could get deltoid DOMS.

With this in mind I carried out my own experiment. And tried a whole range of different splits

Caveat – I don't bother with calves or forearms! And didn't really count any core exercises, although I did them.

And the nature of my workouts is they will not last longer than an hour. Therefore no 2 hour marathon sessions.

Of course. it wasn't a real experiment, there was no control group, I wasn't using ultrasound to see if my muscles had got bigger.

A few rules I set myself:

1) Try and feel every rep, get that mind muscle connection, don't worry about weight
2) Use machines, cables, body weight, dumbbells
3) Avoid the big compound barbell movements like deadlifts, squats, military press I had used extensively in the past. One exception is I did try some high rep squats.
4) Keep rep ranges high, 10-12, or even higher 15+, unless doing rest pause sets.

With all that in mind, here are the splits I tried, and what I think are there advantages and disadvantages,

The classic split.Day 1: Chest & TricepsDay 2: Back & BicepsDay 3: LegsDay 4: Shoulders
This is still probably the most popular split in gyms worldwide or a slight variation on it.

You need to be able to train 4 days a week to be able to do this.

Advantages:

I managed to do 12-14 sets for major muscle groups like chest and back. Exceeding the 10 set threshold that Schoenfeld showed is needed. For smaller muscle groups like biceps and triceps I only managed 5-6 sets. However, these muscle groups are always indirectly trained with other muscles.

Good muscle pump, and soreness. Not too long in the gym.

Disadvantages:

You are only hitting a muscle once per week, not the optimal dosage of twice or more. You have to be able to train 4 x week, if you miss a session, a muscle group wont be trained for 2 weeks.

Less time in the gym, if time crunched do this, because you are only doing one body part. Super pump. The volumes tends to be the same as the classic split, about 12-14 sets per major muscle group, and slightly higher on the biceps and triceps - 9 sets.

Disadvantages:
Need to train 5 x week, still only hitting each muscle once per week, and the volume you can achieve is not much higher than the classic split.

Now I know some people split it down even further, having a quad day and hamstring day and bicep day, but this as far as I went with splitting.Push, Pull, Legs.Day 1: Chest, Shoulders, TricepsDay 2: Back, BicepsDay 3: LegsAdvantages:
If you train 3 x week you hit each muscle at least once. This is achievable for most people. If you train 6 x week, you hit every muscle twice, this is not achievable for most people. Makes you train legs as you have a whole day dedicated to it.

Disadvantages:
You only hit each body part once. I don't like doing shoulders and chest on the same day , I find at least one of these muscle groups will suffer. In my case, my chest is weak and doing shoulders means I can't hit the chest as hard as I want. A whole day dedicated to legs can be taxing, and if you're a bro like me and don't really want to have a whole dedicated to legs you end up dreading it.

Push Pull, basically combine legs into day 1 and 2Day 1: Pushing - Chest, Shoulders, Quads (leg pressing pattern), tricepsDay 2: Pulling - Back, Hamstrings/Glutes (hinge pattern), bicepsAdvantages:When most people talk about total body training, this is the split they actually mean. You can cover all your muscles in 2 sessions. And you can then work on multiples of this, train 4 x week (achievable for most), or even 6 times. Less taxing on the legs in each session but it is still making you train legs!

Disadvantages:
As in the previous split, I think shoulders and chest training can interfere with each other. Less exercises per body part, which means less sets per session - which mean you could end up doing less than 10 sets if you only train twice, however if you train 4 x week you will make up for this and do more volume than the classic split.My variation:Day 1: Chest, Back, BicepsDay 2: Shoulders, Legs, TricepsAdvantages:
Same as push pull except now chest and back are on the same day. This means you can superset exercises more effectively for these body parts, which is a good way to train and can make your workout more time efficient. Putting chest on a different day to shoulders and triceps allows you to hit these pressing exercises without so much interference in a workout.

Disadvantages:

You will probably lower the volume on one body part to fit the workout in, for me this was legs.

This is 3-4 sets per exercise per body part per workout, 7 exercises
per workout.

Advantages:

You hit every body part in the workout. Which means if you only
manage to train once or twice that week you have covered everything.
If you train 3-4 times you have done 9 to 16 set per body part. Which
means the dosage of sets is the same or more than a body part split
over a week.

And you are hitting each body part 3 or 4 times a week.

Disadvantages:

Once you are beyond beginner level this is a taxing workout. Several
times I left out the triceps or only did one set because of time
constraints and fatigue and the feeling I had worked them enough with
the chest and shoulder exercises.

Flexible:

This is generally how I train most of my clients, a push exercise, a
pull exercise, squat exercise, hinge exercise, then core. For clients
looking for general health and only training twice a week, I find
this the best approach. When I write programmes for people who want
to train 5-6 x week, or compete in something I take a different
approach.

You can use this format to make an easy day or a conditioning day or a big intense day, depending on how you are feeling.

Using the total body split approach you can change the emphasis of the day, say you are not feeling it one day, you go easy and for isolation. For example, 2-3 set x 12-15 reps of

Pec flye machine

Rear delt machine

Latpulldown

Lying leg curl

Goblet squat

Cable bicep curl

Cable tricep pushdown.

OR of you want a more conditioning based day:

DB Snatch

Pull Up

Press up/Burpee

Squat Jump

KB Swing

not hypertrophy but you get the idea. OR if you really want a big hypertrophy day you hit the big guns of dumbbells and compound lifts for high reps.

Why don't most lifters in the gym use a total body split?

Despite the evidence showing training a muscle group multiple times
per week for a few sets each session will result in gains and results, nearly every 'serious' guy in
the gym does not train this way. Why so? I think, there is a
psychological element, lack of muscle pump and soreness (even though
DOMS not correlated with growth) means they don't feel they have
trained hard enough or hit the muscle with enough volume. And the
overwhelming perceived gym wisdom – every bodybuilder uses a
training split.

And lets face it, some of us like the variety, the pump, the volume
and doing legs 4 x week is hard!

I've seen several people online says that body part splits are okay
for beginners and those on drugs but too hard for anyone else, and once you are intermediate and drug free you should go total body. I can
only assume these people haven't actually tried to do a total body
training session. A total body session is way harder psychologically
and physically than doing 'chest' day. I think most of these people
conflate total body training for push/ pull.

Conclusion. Which
is best.

The answer as always, it depends on what you enjoy, how many times a
week you have to train. And having enough variety to keep it
interesting and your body responding.

In general I ended up hitting about 12-13 sets per week for bigger muscle groups when doing various body part splits. When carrying out total body training this reached a peak of about 16 sets (4 sets per muscle group per workout for 4 workouts) and about 6-12 for smaller muscles, again with the highest number being hit when total body training – 3 sets of biceps per workout for 4 workouts = 12 sets (but of course triceps and biceps would have been indirectly hit on chest, back and shoulder exercises).

Now, for some Bro's this is low, it is not unusual to hit 20 sets per muscle group per session. But the research doesn't really say if this is actually worth doing. Does your intensity drop until you are barley getting any muscle stimulation with such an approach? And I am assuming you are drug free.

My favourite split is probably:

Day 1: Chest, Back Biceps

Day 2: Shoulders, Legs

or

Day 1: Push – Chest, Shoulders, Squat(Quads), Triceps

Day 2: Pull – Back, Biceps, Hinge(Hamstring/Glutes)

This way, training 4 x week I hit each part twice and feel I am
getting enough volume.

Now if you are looking to emphasize a certain muscle you could target
that multiple times per week and de-emphasize other muscles. For
example, if you wanted to target glutes you could train them 2-4 x
week, and if you are not bothered by chest only train it once.
After all the research shows you can still get hypertrophy with once a
week, but you get more if train the muscle twice or more.

If you are not sure how many times a week you can train and it can
vary at short notice go total body.

If you like short sessions but like to train every day a traditional
body part split could be for you.

Next time.

In the next few parts of this, I will cover how many exercises per body part. The best training techniques and methods. And the best exercise for each body part.

------------------------------------------------

*Definition of a set:

As always the question is what counts as a set. For the purposes of this, warm up sets were not counted, these would typically occur on the first exercise of the day, or if it was a new exercise or machine and I had no idea what weight to use, so started light and built up. Actual sets were 'hard' or to failure.

**Definition of a body part:

Body part splits are by their nature somewhat artificial, especially when it comes to multi-joint compound exercises. For example, is a squat quads, hamstrings, glutes, adductors or back? Well for the purposes of this I'm going with the traditional definitions. Your brain doesn't know muscles, it only knows movements, but EMG activation and soreness, pump etc tell us what was working – and these normally follows the traditional definitions.

Then there is the perennial worry of putting an exercise on the right day – is the dumbbell pullover on chest day or back day or arm day?! Is the shrug a back or shoulder exercise? My answers – pullover goes on back day, and if you do shrugs they are on shoulder day! All I can say is you decide and stop worrying so much.

Monday, February 6, 2017

I attended this course on 4th February at the Anglo-European College of Chiropractic in Bournemouth. I previously attended McGill 1 ('Building the ultimate back: from rehabilitation to performance') in Dublin in 2015.

To see the general description of Professor Stuart McGills courses and his books and publications go here. I assume by reading this blog you already know who he is.

Now, I'm not going to give the detail of the course, if you want that you can pay for the course yourself! But I will compare McGill 1 and 2, give a few insights and suggest whether it is worth you doing the course yourself if you are interested. Also, McGill doesn't let you take pictures of video either, so none of that here.

Anything in quotation marks is a quote from Stuart McGill unless otherwise stated.

McGill 2.

The course is one day, and split in two halves. The morning is lectures covering the theory, movement screening, imaging and examples from various research studies.

The afternoon is the practical going through various tests, movement screens, and practical recommendations in a clinical environment. In this case using Chiropractor plinths - which I must say are bizarre and not very good if you are not doing Chiropractic manipulations! Apparently McGill has presented at AECC on several occasions, so they should have known that the treatment tables they had were not going to be any good for the practical things we were doing.

Movement Screens.

McGill is quick to point out that he is not going to give you a simple system like an FMS to use. There is no simple screen or test with complicated back pain cases.

He covers his research into the FMS - which he also does on McGill 1. He probably spent more time on this in McGill 1.

There is an assumption that people on this course had done McGill 1, but it seemed most people hadn't. Most people on McGill 2 were Chiropractors (surprising eh, being at a Chiro school) whereas I would say at McGill 1 there were more athletic trainers.

In short, even though he has a lot of good things to say about Gray Cook and suggests any new trainer learns the FMS, this is not going to be enough for anyone trying to be a top notch clinician. In essence the FMS is a three chord punk song whereas the McGill assessment is "jazz".

For example, the overhead squat test in the FMS, which requires very good shoulder mobility to score a 3, but "shoulder mobility is a gift from God!', not necessarily something you can change.

His approach is about "converging on a precise diagnosis".

This is where his scientific background comes in. You formulate your hypothesis, and then test it. For example, pain is coming from disc at L.4. Test it, if your wrong, go again.

You can read his books, get his DVDs and listen to podcasts with him in to garner most of what he covers in his seminars. However, there is that extra quality to seeing him in a real life situation. He has charisma, a wealth of knowledge and despite protestations that he is no clinician - obviously is gifted in this area as well as his ability to relate to people.

He has worked with so many different types of people from professional hockey, NFL, MMA, rugby, powerlifting, as well as every day people with everyday jobs with back pain that has been dismissed or misdiagnosed (or not diagnosed at all). He is normally the last resort, if you are seeing him, you are desperate and have seen 10 other experts; his approach has to work.

He brings all this into the lecture theatre, at his best when going off on tangents, citing a research study, talking about specific patients, answering questions - but genuinely listening and not afraid to give strong opinions and say "I don't know" when he doesn't.

For example, I asked him why people sit into their pain, it seems counter-intuitive that someone who is forward flexion intolerant would adopt that posture. He said he didn't know why people did it, but they do and we don't know why.

Or, a friend of mine who is in his 2nd year at Chiropractor school asked if McGill ever saw acute cases. He doesn't, by the time they reach him they are chronic. He said the acute cases are for the clinicians and manual therapists.

Context.

His approach is all about context. He gives the example of posture, no variability and too much variability in posture will result in injury, there is a "sweet spot" in the middle. However, in the weights room there should be zero variability (not in that everyone should squat or deadlift the same) but when you have found the best technique for you or a client, you should be fastidious with every rep.

He also gives examples of very good winning athletes with so called 'poor movement', are you going to change their posture when they are winning and not in pain? Of course not.

He also covered several studies in the morning session. Including one on firefighters and movement screening, and how some moved better with load and some moved worse with load. And studies on changing hip mobility, stretching, and trying to change peoples lordotic spine curves.

Stop trying to fit a pentagon shaped peg into a square hole. Everyone is different.

Non specific back pain and imaging.
If you really want to wind up Prof. McGill mention non specific back pain and general exercise recommendations.

He is dismissive of the medical profession that gives this diagnosis (no one ever had non specific head pain and then was told to have surgery anyway to remove part of the head!) and also some radiologists and their inability to interpret an MRI.

In the morning session of McGill 2 he briefly covers medical imaging and differential diagnosis.

For example, MRI might show a disc bulge at L.2, but if all the symptoms show a problem with L.4, then surgery in L.2 is not going to do anything, even if the MRI shows 'abnormality' there.

In fact, he is very much certain that in 95% of cases that have been told they need surgery you can help them avoid it.

I think one of the other attendees used the phrase "Victim Of Medical Imaging Technology" - VOMIT. Haha. Yes imaging is a fantastic tool but know its limitations.

People giving general exercise recommendations like 'do yoga or pilates' is also lazy. Know the limitations of research where people are diagnosed with 'general back pain' and given 'general exercise'.

In terms of differential diagnosis, McGill interestingly says he has only come across two cases of piriformis syndrome - it is very rare. But, as anyone working in this field knows, people get told all the time they have piriformis syndrome and advised to drive a lacrosse ball into it.

These were interesting, and I will have to think about them more from a neuroscience point of view. The neural resonance effect is when someone has a shuddering in a 8-10 Hz range before being able to do a movement like stand up. This appears to be coming from the Motor Cortex itself. This is easier to demonstrate than explain.

At this point he mentioned visualization and trying to lay down myelination and form new engrams (the software in the brain needs updating, the hardware is fine) of movement. This very much chimes with what I've been reading recently in neuroscience, neuroplasticity and long term synaptic potentiation.

The assessment.

I think what he is trying to get across is how complete the assessment of the person in front of you has to be. From observing how they get out of their car, walk up the stairs, open the door, the look on their face, their complete history, how they sleep, how long they sleep, are they a type A or B personality and on and on.

He doesn't have a set assessment form. Every person is different.

You need to see how they move when fresh, when under stress, when under fatigue - 'break them down' and see what their movement does.

"What matters most to that person" is what you need to focus on.

Is it getting down on the floor and playing with their kids or returning to the NFL or running 10k? There is not one route.

When you have tested the hypothesis, and have a plan you then need to "coach movement not corrective exercise"

You should then "know the goal of the training programme and every single exercise."

The practical.
In the afternoon McGill then goes through the various practical assessments such as heel drop test, seated compression and things like neural flossing. All looking to identify if there is a stability problem, what are the triggers etc. Too many to mention here, with too many pearls of clinical wisdom.

But, I think if you hadn't read his books or watched his DVDs this section could be overwhelming. I would recommend familiarizing yourself with these before attending the course.

Yeah I'm the fan boy who bought the books when they originally came out over 10 years ago. I would read these or watch his assessment DVDs before attending the course. These are my books from 2002 and 2004, the latest editions contain more recent research.

His assistant Joel (website for his facility here) covered the hip assessment, I believe he is an S&C coach.

By 6pm everyone was flagging and there was information overload. And left me with a couple of final thoughts on how to integrate all this information.

Three hour assessment.
In reality I don't think anyone in that room apart from McGill is going to go away and start doing three hour back assessments. However, I think everyone can take something away and make their approach more rigorous. We all get stuck in patterns, become a bit lazy and default to certain ways of thinking , or diagnosis (if that's what you do).

Courses like this re-energise you.

McGill 1 or 2?

McGill 1 covered the research for the exercises more in depth and had a big practical element going through cat camels, bird dogs, side bridges, curl ups, glute exercises and more. Afterall McGill 1 is 2 days long.

If you are an athletic trainer, McGill 1 is the course to do. If don't have access to a therapy couch or your job doesn't allow hands on testing and assessment then there is not much you can practically take away from McGill 2.

From a clinician/ therapist point of view, McGill 2 is going to give you more assessment tools and some treatment options that can be done in a clinical setting and help the client can move better. But if you don't know the big 3 exercises, what a hip hinge is, and more, then it doesn't give you much to give your client to take away and do. For example, McGill mentioned the side bridge on the course and some peoples obsession with making it harder, but said that lifting a leg in a side bridge can double the spine load. If you don't know how to do the side bridge in the first place, this information may not be of use.

McGill 1 cover more things you can do with athletes as well. He covers deadlifting technique, squat technique, neural drive and more. In McGill 2 he only briefly mentions the spate of end plate fractures from people deadlifting and broken pelvic rings from people going too heavy on unilateral leg work.

In someways, it might be better to have the courses the other way round.

We had more time on McGill 1, McGill 2 seemed like we were rushing through the tests and assessments in the afternoon. And these are subtle things, with nuance that take time to learn. In some ways trying to cram too much in can cause confusion and lack of clarity.

On McGill 1 we were given a pdf of all the lectures. On this course there was no pdf or printed copy of the slides provided. This would have been useful to have.

Questions.
Some of these questions have only occurred to me after the course, some I had on the day.

McGill 2 doesn't give you an exercise pathway as such. For example, someone has a underhook at L.3, does this change the way you do the cat camel or bird dog? Aren't you going to do the big three exercises regardless of outcome?

Why do some people sit into their pain?

Why do some people have "reversed perception" and constantly self manipulate, how can you stop them?

Does any professional team or facility have a robust screening/assessment process that has been shown to reduce injury and improve performance by individualizing programmes?

Would it be possible to see neural resonance traces on an EEG or fMRI?

As always courses like this always throw up more questions and more to learn.

As McGill says "It depends" and "We are playing Jazz here". Treat or train the person in front of you, adapt and freestyle as needed, but use science and logic as your guide.

Closing thoughts.
You could learn nearly all that is covered on the course from McGills books, DVDs and research publications.

But by going on the course, you learn something more. It gives you an insight into how to interact with clients and patients. You see the man in action and his thought process.

He has just retired and is winding down, so if this is your thing now is probably the time.

I believe AECC billed this as a more intimate course than McGill 1 but it seems there were as many people as McGill 1, with 50+ other people in the room.

But even if you only take away 1 or 2 new bits of information or a way of phrasing something or carrying yourself in front of client then it was worth it.

I preferred McGill 1 as a course, and from McGill 2 I enjoyed the morning lectures session the most. It has given me a list of research to follow up. But maybe that's just my bias of wanting to know more about the research and not being so clinic based.